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These problems can be due to the overproduction or underproduction of hormones or if the tumors grow large enough to press against areas around the pituitary gland, such as the optic nerves, which help you see.
The pituitary gland, which is about the size of a pea, is at the base of the brain. Although it is small, the gland is important and is known as the "master gland." It makes growth hormone (GH), which plays a part in growth in children and metabolism in adults, and prolactin, a hormone important for breast milk production. The pituitary gland also makes hormones that control the function of other glands, including the thyroid, adrenals and gonads (ovaries in women and testes in men).
Types of Pituitary Tumors
Pituitary tumors may occur in up to 15% to 20% of people, but tumors requiring treatment occur less frequently and often are not diagnosed.
There are two main types of pituitary tumors.
Functioning Tumors: These pituitary tumors cause the body to make too much of certain hormones. Hormones that may be overproduced by such pituitary tumors include:
Prolactin: Prolactin stimulates breast growth and milk production in women. A pituitary tumor that makes too much of this hormone is called a prolactinoma. This is the most frequent type of pituitary tumor.
Growth hormone (GH): GH plays a part in height in children and the body's metabolism. Tumors that make too much GH cause acromegaly (gradual enlargement of body parts) in adults and gigantism (abnormally large growth) in children.
Adrenocorticotropic hormone (ACTH): This hormone tells the adrenal glands to make cortisol, which plays a role in the body's response to stress. It also helps regulate blood pressure and heart function, among other duties. Too much ACTH leads to Cushing's disease.
Thyroid-stimulating hormone (TSH): Pituitary tumors that make too much of this hormone cause the thyroid to release large amounts of thyroxine, causing hyperthyroidism (overactive thyroid). This is the most rare type of pituitary tumor.
Non-functioning Tumors: This type of pituitary tumor does not make hormones that cause symptoms, and it is the second most frequent type of pituitary tumor. They may cause problems if they grow large and press against other areas, such as the optic nerve or other nerves. Non-functioning pituitary tumors also can interfere with the pituitary gland's normal production of hormones.
Pituitary cancer (carcinoma): In rare cases, the cells in a pituitary tumor can become cancer and metastasize (spread) to other areas of the body. In most cases, pituitary cancers make hormones, usually prolactin and ACTH.
Pituitary Tumor Risk Factors
A risk factor is anything that increases your chance of getting a disease. The only proven risk factor for pituitary tumors is inheriting a condition that makes you more likely to develop a pituitary tumor, such as Multiple Endocrine Neoplasia (MEN1) or Family Isolated Pituitary Adenoma (FIPA).
Not everyone with MEN1or FIPA gets a pituitary tumor. However, if you or someone in your family has this disorder, it’s a good idea to discuss your risk with your doctor.
Some cases of pituitary tumors can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Pituitary gland tumors often do not have symptoms in the early stages. When they do have symptoms, they vary from person to person. Many patients live with pituitary tumors for years before the tumors are found. Symptoms often are slow to develop and often are like those of other medical problems.
If a pituitary tumor grows too large, it may press on normal pituitary gland tissue. This may cause the pituitary gland not to work correctly and decrease levels of pituitary hormones. If the tumor presses against other parts of the body, symptoms may include headaches, double vision and loss of vision due to pressure on the optic nerves. When a pituitary tumor causes other glands to make too much hormone, symptoms depend on the gland(s) involved. Pituitary tumor symptoms may include the following:
Adrenocorticotropic Hormone (ACTH): Too much ACTH leads to Cushing's disease. Symptoms of Cushing's disease may include:
- Rounded "moon" face
- Weight gain, particularly in the trunk and abdomen
- Thinning of the skin
- Wide purple-red stretch marks
- High blood pressure
- Muscle weakness
- Slowing of growth (in children)
Growth Hormone (GH): In children, too much GH causes gigantism (abnormally large growth). In adults, too much GH causes acromegaly. The symptoms of acromegaly are:
- Hands, feet, jaw and/or forehead gradually grow larger
- Coarse facial features, such as thickened skin and enlarged nose or lips
- Heart problems
- High blood pressure
- Excessive sweating
Thyroid-Stimulating Hormone (TSH): Too much TSH may cause:
- Weight loss
- Rapid or irregular heartbeat
Prolactin: Too much prolactin causes different symptoms in men and women.
- Milky discharge from the nipples
- Irregular or absent menstrual periods
- Erectile dysfunction and/or impotence
- Loss of body hair
- Decreased sex drive
- Rarely, increased breast growth (gynecomastia)
These symptoms do not always mean you have a pituitary tumor. However, it is important to discuss any symptoms with your doctor, since they may signal other health problems.
Pituitary tumors can be difficult to diagnose, particularly in the early stages. In fact, many pituitary tumors go undiagnosed for many years. Blood tests used to diagnose pituitary tumors can be complex, and they require special expertise. Our specialized endocrinologists and neurosurgeons are among the most skilled and experienced in diagnosing pituitary tumors.
If you have symptoms that may signal a pituitary tumor, your doctor will examine you and ask you questions about your health and your family history.
One or more of the following tests may be used to find out if you have a pituitary tumor and how large it is. These tests also may be used to find out if treatment is working.
- Blood tests
- Urine tests
- Saliva tests
- Specialized testing that requires frequent sampling of the blood, saliva and/or urine
- Imaging tests, which may include:
- MRI (magnetic resonance imaging) scans
- CT or CAT (computed axial tomography) scans
To ensure the best chances for successful treatment, you should be cared for by experts who specialize in pituitary tumors and see a high volume of patients. MD Anderson's experienced physicians customize your care to deliver the most advanced treatments with the least impact on your body.
Like all surgeries, pituitary tumor surgery is most successful when performed by a surgeon with a great deal of experience in the particular procedure. The neurosurgeon's expertise is especially valuable if your treatment includes surgery, since the pituitary gland and nearby structures can be damaged during the procedure.
MD Anderson surgeons are among the most skilled and recognized in the world. They perform a large number of pituitary tumor surgeries each year.
In addition to neurosurgeons, your specialized medical team may include endocrinologists, neuroradiologists, pathologists, neuro-ophthalmologists and radiation oncologists. The team meets regularly to discuss your care, and they communicate closely with you to keep you updated on progress.
Our Pituitary Tumor Treatments
If you are diagnosed with a pituitary tumor, your doctor will discuss the best options to treat it. This depends on several factors, including where the tumor is, how big it is and the specific hormones it affects.
Your treatment will be personalized to your particular needs. One or more of the following therapies may be recommended to treat the tumor or help relieve symptoms.
The pituitary tumor may be surgically removed. Like all surgeries, pituitary tumor surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. MD Anderson surgeons are among the most skilled and recognized in the world. They perform a large number of surgeries for pituitary tumors each year.
You may be given one or more medicines to help reduce hormone levels or shrink the pituitary tumor. Hormone replacement may be given if hormone levels are low.
MD Anderson provides the most advanced radiation treatments to treat pituitary tumors. New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target pituitary tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Why come to MD Anderson for pituitary tumor care?
The specialists in the Pituitary Tumor Program at MD Anderson's Endocrine Center are among the nation's most experienced and skilled experts in diagnosing and treating pituitary cancer and benign (not cancer) pituitary tumors. Your personal medical team for pituitary tumor care may include endocrinologists, neurosurgeons, neuroradiologists, pathologists, neuro-ophthalmologists and/or radiation oncologists, as well as a specially trained support staff. They communicate and collaborate closely with each other – and with you – to coordinate your treatment.
Comprehensive, Expert Care
Because the pituitary gland is delicate and can be damaged during surgery, it is vital that your surgery be done by a specialized neurosurgeon with a high degree of experience. MD Anderson's surgeons complete many pituitary tumor surgeries each year, and this increases your chance for a successful outcome.
As one of the country's foremost cancer centers, we are constantly researching new advances, and we take part in many multi-center clinical trials. This means we offer clinical trials for new treatments of pituitary tumors, which may be difficult to find elsewhere.
And, at MD Anderson you're surrounded by the strength of one of the nation's largest and most renowned comprehensive cancer centers, which has all the support and wellness services needed to treat the whole person – not just the disease.
When I went to see my gynecologist for my annual exam in November 2016, I brought up some concerning symptoms I’d noticed throughout my body. In recent months, I’d experienced joint pain in my knees, swollen feet, carpal tunnel syndrome and excessive sweating and snoring. Additionally, my hands were so swollen my rings had to be cut off, and I noticed changes in my face, like the bridge of nose getting wider.
I thought some of these symptoms were just signs of aging. Never in a thousand years would I have thought I had a pituitary tumor.
Thankfully, my doctor took my concerns seriously and ordered a blood test. Several days later, he called with the results: my growth hormone levels were nearly three times higher than the normal range. He said it was likely caused by a benign (noncancerous) tumor of the pituitary gland and referred me to a local endocrinologist.
The pituitary gland is located at the base of the brain and produces a number of important hormones that control different systems throughout the body. A brain MRI confirmed I had a pituitary tumor about the size of a large marble.
Choosing MD Anderson for my pituitary tumor care
My endocrinologist said I would need surgery to remove the pituitary tumor. He also said I would need to travel, as only a few facilities were capable of doing this type of delicate brain surgery.
MD Anderson was hands-down my first choice because it’s the best of the best! My husband and I drove 300 miles from New Boston, Texas, to Houston to meet with endocrinologist Jeena Varghese, M.D., and neurosurgeon Ian McCutcheon, M.D. Dr. McCutcheon said I’d probably had the tumor for years before I started experiencing symptoms.
My pituitary tumor surgery
On Feb. 1, 2017, I had endonasal transsphenoidal removal of my pituitary tumor. The endonasal transsphenoidal approach is a minimally invasive pituitary surgery that uses the nasal passages to access the tumor.
I tolerated the procedure well, even with a cerebrospinal fluid leak. I experienced wonderful care from the doctors and nurses at MD Anderson. I also had a great support system with my husband, three daughters, family and friends. As I prepared for and recovered from surgery, I found comfort in the “Clinging Cross” my daughter gave me as a reminder of God’s constant presence.
Symptoms improve after pituitary tumor surgery
Just four days after my surgery, I was discharged from the hospital and headed home. My symptoms have improved tremendously. My hands and feet have downsized, and my face has slimmed considerably. My joint pain is so much better. The snoring is also gone, and I just feel so much better overall.
Less than two months after surgery, my growth hormone levels returned back to normal, and Dr. Varghese says I don’t need any further treatment at this time. I feel very fortunate and blessed.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.